Out-of-Sequence Placement of Deceased Donor Kidneys Is Exacerbating Inequities in the United States

Sumit Mohan^{1

2

3}, Miko E Yu^{1

2}, Joel T Adler⁴, Lindsey M Maclay^{1

2}, David C Cron⁵, Jesse Schold^{6

7}, Syed Ali Husain^{1

2}

Affiliations

¹ Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York.
² Columbia University Renal Epidemiology Group, New York, New York.
³ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
⁴ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, Texas.
⁵ Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
⁶ Department of Surgery, University of Colorado, Aurora, Colorado.
⁷ Department of Epidemiology, School of Public Health, University of Colorado, Aurora, Colorado.

Sumit Mohan et al. Clin J Am Soc Nephrol. 2025.

. 2025 Sep 24.

doi: 10.2215/CJN.0000000869. Online ahead of print.

Sumit Mohan^{1

2

3}, Miko E Yu^{1

2}, Joel T Adler⁴, Lindsey M Maclay^{1

2}, David C Cron⁵, Jesse Schold^{6

7}, Syed Ali Husain^{1

2}

¹ Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York.
² Columbia University Renal Epidemiology Group, New York, New York.
³ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
⁴ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, Texas.
⁵ Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
⁶ Department of Surgery, University of Colorado, Aurora, Colorado.
⁷ Department of Epidemiology, School of Public Health, University of Colorado, Aurora, Colorado.

No abstract available

Keywords: health policy; kidney transplantation; minority health and disparities.

References

1. Adler JT, Husain SA, King KL, Mohan S. Greater complexity and monitoring of the new kidney allocation system: implications and unintended consequences of concentric circle kidney allocation on network complexity. Am J Transplant. 2021;21(6):2007–2013. doi: 10.1111/ajt.16441 - DOI
1. Puttarajappa CM, Hariharan S, Zhang X, et al. Early effect of the circular model of kidney allocation in the United States. J Am Soc Nephrol. 2023;34(1):26–39. doi: 10.1681/ASN.2022040471 - DOI
1. Israni AK, Salkowski N, Gustafson S, et al. New national allocation policy for deceased donor kidneys in the United States and possible effect on patient outcomes. J Am Soc Nephrol. 2014;25(8):1842–1848. doi: 10.1681/ASN.2013070784 - DOI
1. Husain SA, King KL, Pastan S, et al. Association between declined offers of deceased donor kidney allograft and outcomes in kidney transplant candidates. JAMA Netw Open. 2019;2(8):e1910312. doi: 10.1001/jamanetworkopen.2019.10312 - DOI
1. Mohan S, Chiles MC. Achieving equity through reducing variability in accepting deceased donor kidney offers. Clin J Am Soc Nephrol. 2017;12(8):1212–1214. doi: 10.2215/CJN.06220617 - DOI